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Excerpt:
Introduction High-sensitivity C-reactive protein (hs-CRP) is a blood test that flags even low levels of inflammation in the body. It has become famous as a simple marker of cardiometabolic risk (heart disease and diabetes). Because researchers are exploring links between inflammation and glaucoma, patients may wonder if hs-CRP relates to glaucoma. In fact, current evidence shows that hs-CRP is not specific to glaucoma. Instead, high hs-CRP usually reflects broader health issues (obesity, smoking, sleep apnea etc.) that also carry cardiovascular risk. In this article we summarize what studies say about hs-CRP and glaucoma, explain the role of immune cells in glaucoma, and offer practical steps (weight loss, exercise, diet, dental care, sleep evaluation) to lower inflammation. We also explain how to get and interpret hs-CRP and related tests. Importantly, we emphasize that managing eye pressure and vision loss in glaucoma remains the priority, and hs-CRP is only part of a holistic health approach. Inflammation and Glaucoma: What the Data Show Glaucoma is primarily an optic nerve disease caused by damage to retinal nerve fibers. Intraocular pressure (eye pressure) is the main proven risk factor, but scientists have long suspected that inflammation also plays a role in how glaucoma starts or worsens. This has led to two lines of research: (1) studies of inflammation markers in glaucoma patients’ blood or eyes, and (2) studies of the immune cells (microglia) and inflammatory signals inside the eye. Blood Markers (hs-CRP and Others) Several studies have tested whether people with glaucoma have higher hs-CRP or other inflammatory proteins in their blood. The results have been mixed. Large population surveys generally do not find a strong link between hs-CRP levels and glaucoma diagnosis. For example, the Beijing Eye Study (a population-based survey) found no significant association between hs-CRP and glaucoma (). Likewise, a Korean study reported that when patients with cardiovascular disease were excluded, normal-tension glaucoma patients had the same hs-CRP levels as healthy controls (). In fact, a recent meta-analysis of multiple studies found that blood hs-CRP levels were not significantly higher in glaucoma patients than in people without glaucoma. In short, hs-CRP as a blood marker does not reliably predict who will have glaucoma or how severe it will be. On the other hand, some studies look at other markers of inflammation. For example, researchers have detected elevated levels of cytokines such as tumor necrosis factor-alpha (TNF-α) and interleukins (IL-1, IL-6, etc.) in the eye fluids or tissues of glaucoma patients. A systematic review noted that glaucoma patients often show abnormal TNF-α, IL-6 and IL-1 in the eye and optic nerve tissue (). These local spikes in inflammatory molecules are thought to be part of the disease process, even if the blood CRP is not changed. In summary, systemic hs-CRP is not a specific glaucoma marker. If it is high in a glaucoma patient, it likely reflects general inflammation (due to obesity, arthritis, smoking, etc.), not glaucoma alone. However, evidence of inflammation inside the eye (shown by cytokines in ocular tissues) suggests that neuroinflammation
